How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $5,495.41 Median $6,918.31 Typical High $6,918.31 | Professional | None | $5,495.41 | $6,918.31 | $6,918.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,232.93 Median $13,182.57 Typical High $25,118.86 | Facility | None | $10,232.93 | $13,182.57 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,165.95 | Professional | None | $5,623.41 | $5,623.41 | $6,165.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $562.34 Median $562.34 Typical High $616.60 | Professional | RR · Rental | $562.34 | $562.34 | $616.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,265.80 Median $4,265.80 Typical High $4,677.35 | Professional | UE · Used equipment | $4,265.80 | $4,265.80 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $7,079.46 | Facility | None | $6,606.93 | $6,606.93 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $6,606.93 | Professional | None | $4,897.79 | $4,897.79 | $6,606.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4,073.80 Median $9,120.11 Typical High $11,748.98 | Professional | None | $4,073.80 | $9,120.11 | $11,748.98 |
Martin's Point Setting Professional Modifier None Typical Low $5,495.41 Median $6,918.31 Typical High $6,918.31 | Professional | None | $5,495.41 | $6,918.31 | $6,918.31 |
United Setting Professional Modifier None Typical Low $4,073.80 Median $5,128.61 Typical High $14,454.40 | Professional | None | $4,073.80 | $5,128.61 | $14,454.40 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $831.76 Median $1,047.13 Typical High $1,047.13 | Professional | 55 · Aftercare only | $831.76 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $691.83 Typical High $691.83 | Professional | 56 · Pre-op care only | $549.54 | $691.83 | $691.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $831.76 Median $1,047.13 Typical High $1,047.13 | Professional | 55 · Aftercare only | $831.76 | $1,047.13 | $1,047.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $691.83 Typical High $691.83 | Professional | 56 · Pre-op care only | $549.54 | $691.83 | $691.83 |
Where Maine sits
The same service costs 2.3 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maine· 29th of 51
$6,166
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.